Individual provider Active NPI

Danielle Marie Martin, CTRS

  • Recreation Therapist
  • Kalamazoo, MI
National Provider Identifier
1609170786
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recreation TherapistTaxonomy code 225800000X
License
59015 Issued in MI
Practice address
5990 Venture Park Dr
Kalamazoo, MI 49009-1858
Phone
(126) 953-2147
Fax
(269) 532-1472
NPI assigned
Jan 4, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Recreation Therapist 225800000X 59015 MI Primary

Addresses

Primary practice location

5990 Venture Park Dr
Kalamazoo, MI 49009-1858

Mailing address

5990 Venture Park Dr
Kalamazoo, MI 49009-1858
Phone (126) 953-2147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
59015MIMDRecreation Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1294099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1609170786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5990 VENTURE PARK DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091858",
            "telephone_number": "126-953-2147",
            "fax_number": "269-532-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5990 VENTURE PARK DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091858",
            "telephone_number": "126-953-2147",
            "fax_number": "269-532-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DANIELLE",
        "middle_name": "MARIE",
        "credential": "CTRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-04",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "MI",
            "license": "59015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalamazoo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.